Cultural awareness will improve minority health care, doctor says

9/28/2006

Current disparities in health care among Latinos and other minorities can be attributed to cultural difference of the patients and their physicans, said Dr. Douglas Cifuentes of St. Vincent Mercy Medical Center yesterday.

Dr. Cifuentes, the director of osteopathic internal medicine residency and the outpatient clinic at the hospital, said those walls of misunderstanding and mistrust must be knocked down to improve treatment. He was the speaker at the University of Toledo's Cross Cultural Showcase Dialogue Series on its Health Science campus. A group of about 50, including students and faculty members, attended the speech.

The physician used his own family as an example of how difficult it is to break down cultural differences. He told the audience that his father, who in Colombian culture is the decision-maker in his family, has always been slow to take advice from him about health care issues.

"In times of decision making, whether it was for health or finances, the decisions are made by the father," Dr. Cifuentes said. "My father is kind of a specialist in everything. It's no different in the health care field. I have to wrestle with him on a regular basis to get himself checked.

"From my father's generation, many don't visit their physicians on a regular basis," he said. "Preventive medicine is not only a new concept to our generation but to the older Hispanic generation."

Dr. Cifuentes said barriers to health care exist because many physicians are unaware, and at times lack respect, for the different cultural complexities of each heritage. He said there is not a "cookie cutter" model for the Latino culture, since Hispanics from Cuba, Mexico, the Caribbean, and South American have different cultural identities.

"In the Hispanic community, there is a higher rate of teenage pregnancies, diabetes, hypertension, and cardiovascular disease," Dr. Cifuentes said. "Our concern is not only the higher rates [in these areas] but the lower rates of diagnoses of these conditions. Many times, people are not getting to the proper health professional for the appropriate screening tests.

"When you have a higher [rate] of these problems and a lower diagnoses, you will have lower rate of treatment. With the lower rates of treatments, you're going to have a higher rate of complications. When you look at diabetes, for example, that's exactly what we're seeing."

Dr. Cifuentes said the use of interpreters for Spanish-speaking patients is effective but he also urged students and professionals to learn a second language as a part of providing more efficient services to their patients. He said many physicians in Europe and other countries are proficient in two or more languages.

He urged health care professionals to learn as much about different cultures as possible and said that when all else fails, being sensitive and respectful to the cultural differences of Latinos and other groups can go a long way to helping patients open up and improving their treatment.

Mary Gregory, co-chair of the Mayor's Commission on Minority Health who attended yesterday's forum, said issues of cultural competency and diversity in the health field must be pushed. She said bringing Dr. Cifuentes' message to UT students was critical in their education.

"This is going directly to their quality of service," said Ms. Gregory, a retired nurse and health care educator. "It will define how they are able to relate to people and treat patients. These issues need this kind of attention."

Contact Clyde Hughes at: chughes@theblade.com

or 419-724-6095.